Results of nutritional intervention in children and adolescents with cystic fibrosis

Objective: few studies have verified longitudinally the evolution of the nutritional status of patients with cystic fibrosis. The objective of this study is to follow the evolution of the nutritional status, body composition and energy consumption, macronutrients and micronutrients ingested by children and adolescents by means of nutritional interventions at the Clinic of Cystic Fibrosis/Pediatric Pneumology of the Department of Pediatrics of Universidade Federal de São Paulo (UNIFESP). Methods: 18 patients were involved in this study, thirteen males and five females with ages ranging from 0.3 to 18.4 years. We performed three evaluations: evaluation 1 (M1- prenutritional intervention), M2 after 6 months, and M3 after 12 months. In these three instances we verified: the z score for weight/age, weight/height and height/age and the calculation of a 3-day diet record. We verified the body composition (anthropometry) in M1 and M3. The nutritional interventions were hypercaloric, hyperproteic, with adequate amount of ingested macronutrients and micronutrients.Results: we observed an increase in the z score for height/age (M1=-1.07; M2=-0.69; M3=-0.50) and fat-free mass after the nutritional interventions, without improvement in the z score for weight/height and fat mass. We verified an increase in the energy intake during M2 (139%) and M3 (132%) compared to M1 (106%). Remarkable increase in the intake of protein, calcium, iron and vitamin C by the patients was found. The occurrence of anemia was found in 44% (8/18) of the patients.Conclusion: the improvement of the z score in height/age and fat-free mass was probably due to the increase in energy consumption after the nutritional intervention. A significant improvement in the z score for weight/height and fat mass was not found, probably due to a gain in height and fat-free mass.Objetivo: poucos estudos têm verificado longitudinalmente a evolução do estado nutricional de pacientes com fibrose cística. O objetivo deste estudo foi acompanhar a evolução do estado nutricional, composição corporal e consumo de energia, macro e micronutrientes ingeridos por crianças e adolescentes, mediante intervenção nutricional, no Ambulatório de Fibrose Cística/Pneumologia Pediátrica, do Departamento de Pediatria da UNIFESP.Métodos: a casuística constituiu-se de 18 pacientes, sendo 13 do sexo masculino e 5 do feminino, faixa etária de 0,3 a 18,4 anos. Realizaram-se 3 avaliações: no momento 1 (M1: pré-intervenção nutricional), no M2, após 6 meses, e no M3, após 12 meses. Foram analisados nos 3 momentos: o escore Z de peso/idade (P/I), peso/estatura (P/E) e estatura/idade (E/I) e o cálculo do registro alimentar de 3 dias. No M1 e M3, verificou-se a composição corporal (antropometria). A conduta nutricional foi hipercalórica, hiperprotéica e houve adequação de macro e micronutrientes.Resultados: observou-se aumento significante do escore Z de E/I (M1=-1,07; M2=-0,69; M3=-0,50) e de massa magra após a intervenção nutricional, sem melhora no escore Z de P/E e massa gorda. Verificou-se aumento no consumo energético nos M2 (139%) e M3 (132%) em relação ao M1 (106%). Houve considerável aumento no consumo de proteína, cálcio, ferro e vitamina C pelos pacientes. A presença de anemia ocorreu em 44,4% (8/18) dos pacientes.Conclusão: o aumento no escore Z de E/I e massa magra ocorreu devido a adequação no consumo de energia, após a intervenção nutricional. Não houve melhora significante no escore Z de P/E e massa gorda, em função do ganho de estatura e de massa magra.UNIFESP-EPM Dep. de PediatriaHospital São Paulo Ambulatório de Fibrose CísticaUNISA Faculdade de MedicinaUNISA Dep. de PediatriaUNIFESP, EPM, Dep. de PediatriaHospital São Paulo Ambulatório de Fibrose CísticaSciEL

Patients with multiple sclerosis do not necessarily consume more alcohol or tobacco than the general population

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Prevalência de infecção chagásica em doadores de sangue no estado de Pernambuco, Brasil

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Influência de Publicidade no Comportamento do Consumidor Infantil

Studies have noted the influence of commercials aired by the electronic media consumption behavior of children, especially television. Thus, this work proposes to study the behavior of the child consumer in Brazil, analyzing how the actions of marketing and media may influence the behavior of early consumption of children aged between six and nine years. We used a mixed approach, with the application of an instrument with open and closed questions and multiple choice, about consumer preferences applied to 141 children six to nine years old. It was found that going to the mall and watching television is part of everyday life that the consumer market, the survey also revealed that the most consumed products are toys for children (71.63%), the largest source of product knowledge that arouse desire are the advertisements on television (80.85%) and the infant admiring the appearance of these cartoon television advertisements (36.99%). It appears that the marketing and the media influence the behavior of the child consumer through advertisements on TV, advertisements on Internet and showcase the stores, especially if they are inserted in the malls, once consisting of a tour of great enjoyment for children. Key words: Marketing, Consumer market, Consumer behavior, Child consumer.    

Transcription of toll-like receptors 2, 3, 4 and 9, FoxP3 and Th17 cytokines in a susceptible experimental model of canine Leishmania infantum infection

Canine leishmaniosis (CanL) due to Leishmania infantum is a chronic zoonotic systemic disease resulting from complex interactions between protozoa and the canine immune system. Toll-like receptors (TLRs) are essential components of the innate immune system and facilitate the early detection of many infections. However, the role of TLRs in CanL remains unknown and information describing TLR transcription during infection is extremely scarce. The aim of this research project was to investigate the impact of L. infantum infection on canine TLR transcription using a susceptible model. The objectives of this study were to evaluate transcription of TLRs 2, 3, 4 and 9 by means of quantitative reverse transcription polymerase chain reaction (qRT-PCR) in skin, spleen, lymph node and liver in the presence or absence of experimental L. infantum infection in Beagle dogs. These findings were compared with clinical and serological data, parasite densities in infected tissues and transcription of IL-17, IL-22 and FoxP3 in different tissues in non-infected dogs (n = 10), and at six months (n = 24) and 15 months (n = 7) post infection. Results revealed significant down regulation of transcription with disease progression in lymph node samples for TLR3, TLR4, TLR9, IL-17, IL-22 and FoxP3. In spleen samples, significant down regulation of transcription was seen in TLR4 and IL-22 when both infected groups were compared with controls. In liver samples, down regulation of transcription was evident with disease progression for IL-22. In the skin, upregulation was seen only for TLR9 and FoxP3 in the early stages of infection. Subtle changes or down regulation in TLR transcription, Th17 cytokines and FoxP3 are indicative of the silent establishment of infection that Leishmania is renowned for. These observations provide new insights about TLR transcription, Th17 cytokines and Foxp3 in the liver, spleen, lymph node and skin in CanL and highlight possible markers of disease susceptibility in this model

Enxaqueca em 746 pacientes com esclerose múltipla

Enxaqueca piora o sofrimento do paciente que tem esclerose múltipla (EM). ID-migraine é uma ferramenta útil para seleção de pacientes com enxaqueca e Migraine Disability Assessment (MIDAS) é um questionário que avalia o impacto da doença. O objetivo do presente estudo foi avaliar a presença e impacto de enxaqueca em pacientes com EM. Métodos: Pacientes diagnosticados com EM e tratados em clínicas especializadas foram convidados a responder um questionário online se também apresentassem cefaleia. Resultados: O estudo incluiu 746 participantes com cefaleia e EM que preencheram completamente as respostas. Foram 625 mulheres e 121 homens, sendo 69% dos pacientes com idade entre 20 e 40 anos. Enxaqueca foi identificada em 404 pacientes (54,1%) e moderado a grave impacto da doença foi observado em 68,3% dos casos. Conclusão: Enxaqueca é uma cefaleia primária frequente e incapacitante relatada por pacientes com EM.Migraine adds to the burden of patients suffering from multiple sclerosis (MS). The ID-migraine is a useful tool for screening migraine, and the Migraine Disability Assessment questionnaire can evaluate disease burden. The aim of the present study was to assess the presence and burden of migraine in patients with MS. Methods: Patients diagnosed with MS attending specialized MS units were invited to answer an online survey if they also experienced headache. Results: The study included 746 complete responses from patients with MS and headache. There were 625 women and 121 men, and 69% of all the patients were aged between 20 and 40 years. Migraine was identified in 404 patients (54.1%) and a moderate-to-high burden of disease was observed in 68.3% of the patients. Conclusion: Migraine is a frequent and disabling type of primary headache reported by patients with MS